Provider Demographics
NPI:1326496944
Name:LEON, ASHLEY DIANE (MSN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:DIANE
Last Name:LEON
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 577
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37822-0577
Mailing Address - Country:US
Mailing Address - Phone:423-623-1057
Mailing Address - Fax:
Practice Address - Street 1:229 HEDRICK DR
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:TN
Practice Address - Zip Code:37821-2902
Practice Address - Country:US
Practice Address - Phone:423-623-1057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-25
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000206955163W00000X
TN32666363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse